Choosing the "Perfect" Child: What's Wrong with PGD

Pre-implantation genetic diagnosis is a screening technology used to scan embryos conceived through in vitro fertilization for potential genetic malformations. PGD can screen for diseases such as Duchenne muscular dystrophy, cystic fibrosis, hemophilia, Down‘s syndrome and others.

This method of screening raises many concerns. Prenatal diagnosis which respects the life and integrity of the unborn child and seeks to ascertain which therapies might be beneficial is morally permissible. PGD is used primarily to detect genetic disorders to avoid the birth of human beings with these conditions. When the embryos created through in-vitro fertilization are found to be "defective", they are discarded or donated for research. While we must sympathize with parents who fear passing on an inherited disorder, does anyone have a right to disability-free children or a guarantee to only healthy children?

The June 27, 2001 edition of the Journal of the American Medical Association reported on a case of parents who used PGD to select embryos for the purpose of creating a child who would be a tissue match for a sibling born with Fanconi anemia. Human embryos were created through IVF. 30 were tested-24 were found disease free and 6 were affected. Of the 24 disease free embryos only 5 were deemed suitable for tissue matching. It took four cycles of IVF to achieve pregnancy. Stem cells were retrieved from the child's umbilical cord at birth to treat the sibling suffering from Fanconi anemia.

The final cost in terms of human life: 29 lives were destroyed to create one child who could act as a donor. The 6 embryos carrying the disorder never had a chance at life, neither did the 19 normal who were not suitable matches. And, finally, of the five embryos implanted only one was born-the first three cycles of IVF were failures.

Health Canada states in its document on PGD that "[t]he child born as a result can then be used as a source of compatible tissue". The word ‘used' indicates the central problem with PGD-human life is considered merely a product and of so little value that one child will be created to be "used" by another.

The human embryo has the same moral status as an older person. Human life does not possess or acquire greater moral status at specific points in its development. The life of a two year old has the same value as that of a twenty year old. The life of the human being in the womb or that of the embryo created through in-vitro fertilization has the same intrinsic dignity and deserves the same respect.

Since PGD is done only to determine if the human embryos are carrying markers for certain conditions, resulting in the rejection of these embryos, or for the purpose of selecting a donor sibling, this approach will inevitably lead to the acceptance of a new eugenics. PGD has not produced cures for genetic diseases but instead it reduces the number of children born with these genetic disorders through destruction of the embryo. How can we not say that PGD is in fact permitting genetic discrimination and fostering eugenics?

Margaret Somerville, professor at McGill University Centre for Medicine, Ethics and Law, said:

"In short, the new genetics is functioning as eugenics, but that fact is not identified. Decisions by individuals based on pre-implantation genetic diagnosis (PGD) of IVF embryos, or prenatal screening of foetuses mean we will eliminate certain groups of people, for example, Down's Syndrome children, from our society. In short, an outcome that would never be acceptable as public policy is being implemented through the accumulation of individual choices."

"We should remember, however, that the ethical tone of society is set by how it treats its weakest, most in need, most vulnerable members..."

As Dr.Chris Hook, a consultant in Hematology and Medical Oncology at the Mayo Clinic in Rochester has said: "With PGD, the explicit point is that if you don't have the right genes, your young life will end. It is the true commodification of children and human life."

Weeding out ‘undesirable" offspring through the use of PGD constitutes a further descent on the slippery slope of our utilitarian approach to human life. What will the future hold for families who refuse testing and have children with disabilities and inherited disorders? Will society consider it unacceptable that parents have allowed these children to be born when their birth could have been prevented through PGD? After all, providing care and other social services is much more costly.

Advocates for the disabled have also expressed concern about prenatal screening. Indeed disabled people will come to receive the message that their lives are not worth living or that disability is a fate worse than death. What an extraordinary judgment to make on someone's life! How demoralizing a message this will be for those suffering from inherited disorders.

Cells for Life in Markham, Ontario is an establishment providing storage of umbilical cord blood for families who wish to store their babies' cord blood. Dr. Peter Hollands of Cells For Life has said that if greater effort was placed on collecting cord blood after birth in our hospitals, these umbilical cord blood banks would make it possible to find a suitable tissue match for almost everyone needing stem cell therapy. Hence PGD, IVF and the creation of sibling donors are not necessary to obtain a tissue match.

True equality will exist when every child is welcomed regardless of disability. It is impossible to value the lives of those affected with particular conditions while at the same time permitting their destruction with pre-implantation genetic diagnosis.